[Retroperitoneoscopic anterior approach to the L2, L3, L4 vertebral bodies].

PURPOSE OF THE STUDY: We present a technique of retroperitoneal video assisted anterior approach of vertebral bodies and adjacent discs on L2-L3-L4 levels without CO2 insufflation. MATERIALS: A videosurgical material is required as well as fluoroscopic control. Ordinary anesthesia methods can be used. The patient is placed in right lateral decubitus. Ay. A3 cm incision is targeted moderately anteriorly at the level of the vertebra. Dissection of the retroperitoneal space is begun by blunt finger dissection and completed by a balloon. A camera is inserted. CO2 insufflation is not used for this open video-assisted technique. METHODS: We have performed 12 arthrodeses with this technique, 11 of them without corporectomy. In one case, a corporectomy with peroneal graft was used. RESULTS: Eleven arthrodesis fused. The possible complications are the same as with a full open procedure. DISCUSSION: Extension of this approach is limited cranially by the 12th rib and caudally by the iliac crest. CONCLUSION: Although this is an easy to perform mini open technique, a learning curve is necessary. Conservation to a full open procedure is possible at any point in the procedure.